A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Response to prophylactic treatment of migraine with Onabotulinumtoxin A (BTX-A) has been noted to be significantly correlated to the perceived direction of headache pain, namely imploding vs. exploding subtype. This study analyzed 3 methods of assessing migraine directionality in comparison to a 30-day headache log; pictorial representation, written description, and physician assessment. Each of these assessment types was shown to have poor agreement with the headache log at the initial visit. However, all 3 assessments displayed excellent agreement at the return visit, as well as significantly improved confidence in patient ability to determine headache directionality.

Obesity is one of the most important health problems in the UK and its prevalence is increasing. It is often neglected, despite it being associated with a range of serious diseases such as coronary heart disease, hypertension, diabetes, gall stones, peptic ulcer, gout and certain cancers. Most of these are reversed by weight loss but there are concerns that many treatments available to the obese are ineffective. The obese and overweight are the largest treatment group seen by dietetic departments and utilise a large proportion of clinic time. It is important that the best, most appropriate treatment is given to these patients based on their needs but, given the shortage of dietitians in the health service and the limited time available, the benefit/cost effectiveness of such work needs to be evaluated. The present study evaluated four methods of advising the obese and overweight including slimming groups and traditional individual counselling. The "multi-professional" approach to administering dietary advice was also reviewed using two groups in cardiac rehabilitation programmes. Dietary assessments by food records, nutrition knowledge by a questionnaire and body weight measurements were taken at the start of the study, at the end of the healthy eating programmes and 6 months after the programmes had finished. The groups advised on an individual basis were assessed at a corresponding time interval. The data obtained were compared statistically for the 6 groups. The attrition rate was highest for the subjects advised in slimming groups and lowest for the cardiac rehabilitation groups. The weight loss was highest for the subjects advised in individual consultations and lowest for the cardiac groups. The nutrition knowledge scores increased for all groups with no statistical differences between the groups. The results are reviewed and the future provision of dietetic services to the obese and overweight is discussed.

The purpose of this study is to explore how young people learn about global poverty and development. Its focus is on the process of learning, understood here as the way in which individuals respond to opportunities to learn about global poverty and development (e.g. in terms of emotion, cognition and behaviour) and the way these responses interrelate in the construction of understandings. The empirical element of this qualitative, constructivist research focuses on nine 12–15 year-olds living in the South and South East of England. Their perceptions of learning about global poverty and development, across a range of contexts, were explored through semi-structured interviews. This data was analysed using a model of learning developed by Jarvis (2006). This model was selected because of its resonance with themes within the empirical data and also within literature and research relating to global education, the academic and personal context of this research. The study proposes a slightly adapted version of Jarvis’ model which better reflects the way in which young people in this study learn about global poverty and development. This adapted model emphasises the role of young people’s emotional response to learning about global poverty, the relationship of this response to a behavioural or action response, and the significance of young people’s reflection on themselves in relation to global poverty and development. This research is unique in two ways: in applying learning theory directly to empirical evidence of young people’s learning about global poverty and development; and in applying Jarvis’ theory of learning to young people. In doing so it highlights the merits of drawing on the rich body of learning theory that exists to explore how young people learn about global challenges and contributes to wider debate about the ways young people learn and become themselves in today’s world.

Class of 2015 Abstract / Objectives: Our specific aim is to assess the changes in patient adherence in response to medication synchronization. Our working hypothesis is that medication synchronization will have a positive impact on patient adherence. Methods: This retrospective pre-post cohort study assessed medication adherence 365 days before and 365 days after enrollment into a prescription synchronization program. There were 5,994 patients included in the study. Seven medication classes and three demographic groups were chosen to assess for adherence. Adherence was determined by calculating mean proportion of days covered. A paired t-test was used to determine statistical significance for each drug class and demographic group. Exploratory analyses were done at 90 days and 180 days before and after the sync date to determine differences in terms of time. An alpha a-priori was set at 0.05 before analysis was started. Results: Current Fry’s Pharmacy patients greater than 18 years old that met the Centers for Medicare and Medicaid Services (CMS) for STARs rating criteria were included in the study. Results at 365 days showed a statistically significant decrease in PDC (p<0.0001), and was not affected by demographics. Conclusions: One year after the implementation of medication synchronization program at Fry’s Pharmacy, a statistically significance decrease in PDC is seen across all categories of chronic medications: statins, ACE-I/ARBs, beta-blockers, CCBs, metformin, thiazides, loop-diuretics, and inhaled corticosteroids. As such, medication synchronization may decrease patient adherence to the maintenance medications evaluated.

Magister Artium (Child and Family Studies) - MA(CFS) / Research suggests that parents feeding practices play a critical role in the development of children tastes, eating habits, nutrition and eventual weight status. Thus if parental feeding practices play such a critical role, the question arises as to whether there is a difference in parental feeding practices that determine different developments in children nutritional habits. Furthermore, feeding practices are possibly based on the nutritional knowledge of parents. The aim of this study was to assess the Body Mass Index (BMI), nutritional knowledge and behaviour of primary care-givers. This study followed the quantitative research paradigm. A sample of 147 staff members, who were primary care- givers of children at a University in the Western Cape was self-selected to participate in the study. Only primary care-givers of children were invited to participate. The primary care-givers were asked to complete two online questionnaires, the Comprehensive Child Feeding Questionnaire (CFPQ) developed by Musher-E-Eisenman and Holub (2007), and the General Nutritional Knowledge Questionnaire (GNKQ) for adults. Data analysis was done by means of the Statistical Package for Social Sciences (SPSS17). Results indicated that the majority of participants were overweight (46% of the participants). Primary care-givers across all body mass index groups did not lack nutritional knowledge but variations in behaviour were found with regard to feeding practices. However similarities were found in the BMI categories in the areas of teaching about nutrition, pressure to eat at meal times and encouraging balance and variety. / South Africa

This study tries to identify the key factors that influence the acceptance of an aggregated electronic bill presentment and payment solution in South Africa. As technology acceptance models are primarily developed and validated in developed countries, a new model had to be respecified to fit the South African context. Two constructs, namely perceived usefulness from the Technology Acceptance Model and a new construct “confidence”, including antecedents, were formulated from our literature review. Using a research instrument of an online survey, we measured the 81 responses received from a judgemental sample of South African internet users. The data was analysed by using linear regression analysis to test the model as well as individual hypotheses. Our respecified model was found to be highly significant providing 31, 2% explanatory power to influence adoption. The confidence construct was only marginally significant and may be an area for future research. The key themes emanating from our research indicates that consumers who value “time savings” and are “self-identified adopters” are likely to be the early adopters of EBPP. Concern for privacy and the perceived advantage to current methods of paying bills online are eminent; however, a majority (96, 3%) of the respondents indicated a willingness to adopt EBPP with 58% indicating regular levels of usage. Copyright / Dissertation (MBA)--University of Pretoria, 2009. / Gordon Institute of Business Science (GIBS) / MBA / Unrestricted

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Cross validation (CV) is widely used for model assessment and comparison. In this thesis, we first review and compare three v-fold CV strategies: best single CV, repeated and averaged CV and double CV. The mean squared errors of the CV strategies in estimating the best predictive performance are illustrated by using simulated and real data examples. The results show that repeated and averaged CV is a good strategy and outperforms the other two CV strategies for finite samples in terms of the mean squared error in estimating prediction accuracy and the probability of choosing an optimal model. In practice, when we need to compare many models, conducting repeated and averaged CV strategy is not computational feasible. We develop an efficient sequential methodology for model comparison based on CV. It also takes into account the randomness in CV. The number of models is reduced via an adaptive, multiplicity-adjusted sequential algorithm, where poor performers are quickly eliminated. By exploiting matching of individual observations, it is sometimes even possible to establish the statistically significant inferiority of some models with just one execution of CV. This adaptive and computationally efficient methodology is demonstrated on a large cheminformatics data set from PubChem. Cross validated mean squared error (CVMSE) is widely used to estimate the prediction mean squared error (MSE) of statistical methods. For linear models, we show how CVMSE depends on the number of folds, v, used in cross validation, the number of observations, and the number of model parameters. We establish that the bias of CVMSE in estimating the true MSE decreases with v and increases with model complexity. In particular, the bias may be very substantial for models with many parameters relative to the number of observations, even if v is large. These results are used to correct CVMSE for its bias. We compare our proposed bias correction with that of Burman (1989), through simulated and real examples. We also illustrate that our method of correcting for the bias of CVMSE may change the results of model selection. / Science, Faculty of / Statistics, Department of / Graduate

Many infrastructure networks rely on each other to deliver utilities and services to the community. In the event of a disaster, these networks can sustain significant damage. It is therefore important to identify interdependencies among networks to mitigate the disaster consequences. In 2003, Public Safety Canada (PSC) and NSERC initiated the Joint Infrastructure Interdependencies Research Program (JIIRP) for this purpose. The research was carried out at six Universities across Canada including the University of British Columbia (UBC). The aim of JIIRP at UBC was to study infrastructure interdependencies during disasters in order to aid in decision making. This involved the development disaster simulation methodology and tool, and the implementation of a case study. UBC's Point Grey campus was used as case study. The campus is located in southwestern British Columbia, a known seismic zone, therefore earthquake disaster scenario was chosen. Reasonable estimations of the expected seismic damage and losses are required in order to simulate a realistic disaster scenario. For this reason, in this thesis, seismic risk assessment was carried out for the buildings at UBC. This involved the development of a building database, the assessment of the expected level of damage to the structural and nonstructural building components, and the estimation of monetary, human and functionality losses. Buildings in the database were classified into prototypes and the damage was estimated for several levels ofintensity using damage probability matrices. As expected, the most vulnerable buildings on campus were those containing unreinforced masonry. These buildings make up 7% of the buildings on campus. The least vulnerable buildings were multi-family residential woodbuildings which account for 27% of the buildings on campus. Losses were estimated following the damage assessments. Casualties were estimated for three times of day. 2PM was determined to be the critical time of day as the campus population is the greatest at this time. Monetary loss and functionality trends were examined with respect to earthquake intensity and it was shown that for moderate intensity earthquakes, the losses depend primarily on nonstructural damage, while structural damage plays the most important role for higher intensities. / Applied Science, Faculty of / Civil Engineering, Department of / Graduate